El acceso al programa de atención a largo plazo en el estado de Washington aumentará gracias a medidas adoptadas durante la sesión legislativa de este año. Pero el programa también se enfrenta a un reto en las próximas elecciones. A partir de 2026, los habitantes de Washington tendrán acceso a hasta $36,500 dólares en beneficios del WA Cares Fund. Un proyecto de ley aprobado durante la sesión legislativa de este año permite el acceso al programa incluso si el contribuyente se muda fuera del estado.

La asistente de atención domiciliaria en WA, Julie Sparkman, dice que se trata de un avance importante para sus hijos adultos.

"La portabilidad de WA Cares es muy importante," asegura Sparkman, "porque uno nunca sabe a dónde va a medida que envejece. A veces la vida te lleva a otros lugares, y la gente debe tener la libertad de hacerlo. No deberían verse atrapados en una situación como única posibilidad de acceder a las prestaciones que han pagado."

Los trabajadores comenzaron a contribuir automáticamente al fondo en julio de 2023, con un poco más del cero punto cinco por ciento de sus cheques de pago. La iniciativa 2124 en la boleta electoral de noviembre permitiría a los trabajadores optar por no participar en el programa. Quienes se oponen a WA Cares dicen que algunas de las personas que pagan el impuesto nunca utilizarán los beneficios del programa.

Sin embargo, si demasiados trabajadores optan por no participar, las finanzas del programa podrían verse afectadas. A los defensores, incluida Sparkman, les preocupa que, si la iniciativa se aprueba, se derogue WA Cares.

"Me siento muy orgullosa cada vez que lo veo en mi sueldo," explica Sparkman. "Me hace feliz porque es mi participación en lo que creo que socialmente debe ocurrir. E incluso si nunca lo uso, estoy muy feliz de ser parte."

En los últimos años, a Sparkman le diagnosticaron cáncer de mama y se lo trataron. Dice que WA Cares podría ser importante para ella en los próximos años.

"A veces el cáncer reaparece. Así que, si tengo un problema en el futuro, quizá la inestabilidad que esto provoque no sea tan grave porque WA Cares existe," dice Sparkman.

Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


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Alabama is running out of time to tackle Medicaid expansion this legislative session.

More than 230 people gathered earlier this month with the group Alabama Arise, urging state lawmakers to prioritize the issue. Their message: Access to health care isn't just a matter of policy, it can be a matter of life and death.

Debbie Smith, Cover Alabama campaign director for Alabama Arise, said as the session winds down, the group will continue to echo the call for increased access to health coverage. She thinks it would not only save lives but revitalize communities across the state.

"Over 80% of our rural hospitals are operating in the red," Smith pointed out. "Not a great stat. About 19 rural hospitals are at immediate risk of closure, and those are the lifeblood of those communities. They're on life support."

Smith emphasized hospitals at financial risk also put their workforce at risk. Those who are against Medicaid expansion believe it is ultimately unaffordable for the state. However, Smith argued it could save the state nearly $400 million over the next six years. According to the Public Affairs Research Council of Alabama, those savings would be enough to cover the cost.

The council's study also showed Medicaid expansion would generate nearly $2 billion of economic growth. Beyond economic benefits, Smith pointed to the stark disparities in maternal and infant mortality rates in Alabama.

She stressed Medicaid expansion would do more than provide health care coverage during pregnancy or postpartum, it is about ensuring comprehensive coverage.

"We've been lucky enough to expand Medicaid coverage up to 12 months postpartum but we still need to figure out how to cover people before they even get pregnant," Smith asserted. "It's really important for people to have health coverage so they can address any kind of issues they might have, like if they have diabetes or high blood pressure that might affect their pregnancy in the future."

With limited time left in the legislative session, she noted one option could be Gov. Kay Ivey's executive authority to enact Medicaid expansion. Smith added using the power could be the simplest path forward, backed by the promise of additional funding from the American Rescue Plan.

A Connecticut bill would expand the state's paid sick leave law.

The initial 2011 law requires 40 hours of paid sick leave for workers at employers with 50 businesses or more. The new bill covers all workers regardless of their employer's size.

Janée Woods Weber, executive director of the nonprofit She Leads Justice, said the legislation can benefit workers without access to paid sick leave.

"These are people for whom taking a few hours off when their child has a cold or perhaps they need to take themselves to a doctor's appointment are the kinds of challenges that many of us don't worry about, those of us who do have access to paid sick days," Woods Weber explained.

Small businesses were concerned about how the change could affect them. To address worries, the bill has a three-year implementation cycle giving them time to adapt. It also creates a task force studying the feasibility of providing tax credits to businesses with the smallest workforces. The bill passed the House and awaits a vote in the Senate.

An estimated 11% of workers are eligible for paid sick leave under the current criteria. Though expanding the law has taken over a decade, Woods Weber argued it has always been necessary.

"Nobody should be forced to make what is often times a very difficult and sometimes impossible choice between their livelihood," Woods Weber emphasized. "Getting a paycheck and getting to take paid time off to take care of themselves or a loved one if they get sick."

She added that once the bill is passed, the state can build off it by allowing people to earn more than 40 hours of paid sick time. Woods Weber said the isolation requirements during the pandemic forced anyone who got COVID-19 to use their allotted sick time all at once for isolation.


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